About the Role

We are an early-stage, venture-backed technology company rebuilding revenue cycle operations for outpatient specialty clinics.

Rather than building another standalone SaaS dashboard that adds extra work for clinical staff, we run a Services-as-Software model. Our platform directly executes the operational workflows required to get specialty clinics paid: intake, insurance verification, prior authorizations, claim scrubbing, and appeal submissions. We use applied machine learning to automate high-volume data extraction and rule checks, while operations specialists handle subjective exceptions.

This is not an unvalidated concept searching for early users. We already manage tens of millions of dollars in annual billing volume across active clinic partners, supported by an established operations group. We are hiring our first dedicated full-stack engineer to work alongside the CEO, take ownership of the software architecture, and expand the platform.

What You Will Build

You will lead technical execution across our core platform. The product is already operating in production with live integrations across electronic health records, clearinghouse connections, and document queues. Your job is to improve reliability, scale the backend, and build out new automation capabilities across several core areas:

• Document Ingestion & Intake: Ingest high-volume fax, email, and EHR referrals. Build pipelines using OCR and vision-language models to classify incoming documents, extract critical clinical fields, and run completeness checks with human-in-the-loop review screens.
• Coverage & Benefits Verification: Query payer clearinghouses and web endpoints to check real-time patient eligibility. Maintain a rules engine that validates medical versus pharmacy benefit routing and formulary restrictions before visits take place.
• Prior Authorization Automation: Generate clinical justification packets by matching chart notes to specific payer guidelines. Handle submission pipelines, track decision timelines, and run portal automation for payers that lack direct APIs.
• Claims Scrubbing: Run deterministic rule checks on claims prior to clearinghouse submission to catch billing discrepancies, missing identifiers, and payer-specific edits before they trigger denials.
• Appeals & Dispute Resolution: Parse remittance files to identify root causes of denied claims. Build tools that draft tailored appeal letters supported by clinical records and published trial literature.
• Operations Control Center: Create real-time monitoring views for accounts receivable aging, clinic collection rates, denial patterns, and reviewer efficiency.

Technical Stack

• Frontend: TypeScript, React, Next.js
• Backend: Python (FastAPI / asynchronous workers), Node.js
• Data: PostgreSQL
• Infrastructure: AWS (ECS, SQS, RDS, S3, Bedrock)
• Healthcare Formats: EDI X12 (837, 835, 270, 271), HL7, FHIR

What We Look For

• Core Experience: At least 6 years of professional full-stack software development experience.
• Language Breadth: Deep hands-on experience in both Python and TypeScript. You should be equally comfortable structuring backend APIs, writing asynchronous background jobs, and building responsive browser interfaces.
• Production Machine Learning: You have designed and shipped real LLM workflows for live users. You understand prompt versioning, structured JSON outputs, multi-step agent actions, tool calling, and evaluation benchmarks. You know how to make generative outputs reliable enough for financial and clinical data.
• Pragmatic Systems Mindset: You can review existing, fast-moving application code, identify reliability bottlenecks, and incrementally improve architectural stability without asking to stop everything for a rewrite.
• Cloud Infrastructure: Solid operational fluency with AWS services, including container orchestration, managed message queues, relational database optimization, and isolated storage.
• Regulatory Awareness: Familiarity with HIPAA compliance, handling protected health information (PHI), and securing vendor data boundaries with Business Associate Agreements (BAAs).

Nice-to-Have Background

• Direct experience building software in healthcare billing, claims processing, revenue cycle management, or prior authorization workflows.
• Prior work connecting to clearinghouse or EHR networks (such as Availity, Change Healthcare, Athena, or specialty practice systems).
• Experience with browser automation and headless scrapers to interact with third-party web portals that lack public APIs.
• Experience building document extraction systems on unstructured, messy medical paperwork.
• Experience designing multi-tenant architectures for business software.

What We Offer

• Equity: Substantial founding equity with real ground-floor ownership.
• Partnership: Direct partnership with the founder and CEO without layers of management or committee reviews.
• Traction: A business with real revenue, live transaction volume, and direct access to clinic users from your first week.
• Location: Remote initially, transitioning to an in-person hybrid setup in New York City.